UROKINASE

It is an enzyme obtained from human urine; now prepared from cultured human kidney cells. It is not antigenic, though fever occurs; allergic phenomena are rare

Indications

Acute myocardial infarction. Deep vein thrombosis. Pulmonary embolism. Peripheral vascular thrombo-embolism.

Dosage

A.M.I.: Therapy should start within 6 hrs. after onset of symptoms. Intracoronary: 6000 i.u./min. dissolved in saline or 5% dextrose. Therapy is cont. until artery is maximally opened, usually 1/2 hr. after initial opening. Total dosage : usually 10,000 i.u./kg i.v.: 250,000 i.u. vial/500,000 i.u. vial to be dissolved in 10 ml/20 ml saline or 5% dextrose 250,000 i.u. (10 ml) bolus i.v. over 5-10 mts. Followed by 250,000 i.u. (10 ml) in 50-100 ml drip over 30 mts. Some patients may require anoth

Contra-Indications

Active gastro-intestinal or urinary tract bleeding concurrent use of anticoagulants-any surgicals procedure within preceeding 10 days. Recent trauma with possibility of internal injuries, severe hypertension,Pregnancy.1st 10 days post-partum sub acute bacterial endocarditis or rheumatic valvular disease. Any purpuric or haemorrhagic disorder.

Special Precautions

Drug which alter platelet functions not be used eg. aspirin, indomethacin etc. Paediatrics: Not recommended. Pregnancy:Use with caution as safety not established. Lactation: Contraindicated. Elderly: Use with caution.

Side Effects

Febrile reactions, haemorrhage.

Drug Interactions

Increases the risk of bleeding with anticoagulants and antiplatelet drugs.